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Background
Treatment satisfaction among patients with moderate-to-severe psoriasis has not been studied and compared across treatments using a validated instrument.
British Journal of Dermatology
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Epidemiology and Health Services Research
Patient satisfaction with treatments for moderate-to-severe plaque psoriasis in clinical practice
- K.C.D. and H.Y. are joint first authors and contributed equally to this manuscript.
- Funding sources This study was supported by grants 1KM1CA156723 (K.C.D.), T32-AR07465 (H.Y., D.B.S.) and T32-GM075766-6 (J.T.) from the National Institutes of Health; a National Psoriasis Foundation Fellowship Award (J.T.); grants RC1-AR058204 and K24-AR064310 from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (J.M.G.), and an unrestricted grant from Eli Lilly.
- Conflicts of interest Statements are listed in the Appendix
Summary
Objectives
To assess patient-reported satisfaction with systemic and phototherapy treatments for moderate-to-severe psoriasis in clinical practice and to correlate satisfaction with disease severity and quality-of-life measures.
Methods
This was a cross-sectional study of 1182 patients with moderate-to-severe psoriasis in the Dermatology Clinical Effectiveness Research Network in the U.S.A. Patients receiving either topical therapies only; monotherapy with oral systemic therapies, biologics or narrowband ultraviolet B phototherapy; or combination therapy with biologics and methotrexate completed the Treatment Satisfaction Questionnaire for Medication version II.
Results
Median unadjusted overall satisfaction scores were highest for patients receiving biologic monotherapies, biologic–methotrexate combinations, or phototherapy (83·3); scores were lowest for those receiving topical therapies only or acitretin (66·7). In fully adjusted models, compared with patients receiving methotrexate monotherapy, those receiving adalimumab, etanercept, ustekinumab, phototherapy or adalimumab with methotrexate had significantly higher median overall satisfaction scores by 7·2–8·3 points, while those receiving topical therapies only had significantly lower overall satisfaction by 8·9 points. Adjusted convenience scores were lowest for patients receiving topical therapies only or infliximab. Modest but significant correlations were found between the overall satisfaction subscale and both the Psoriasis Area and Severity Index (ρ = −0·36, P < 0·001) and the Dermatology Life Quality Index (ρ = −0·47, P < 0·001).
Conclusions
Discernible differences were found in treatment satisfaction among therapies, particularly regarding treatment effectiveness and convenience. Further application of treatment satisfaction measures may inform treatment decisions and guideline development.